More on Insulin-To-Carb Ratios

Teresa Love is a dietitian who works at Howard County General Hospital's Diabetes Education Center along with nurse Mike Taylor, who is also trained in diabetes education. I consulted Teresa yesterday. From her I learned that it is not unusual for a patient to need different insulin-to-carb ratios for different meals of the day.

The liver becomes active overnight pouring sugar into the blood, resulting in elevated blood sugar around dawn. This is the "dawn phenomenon," and its causes are yet more complex than that quick summary.

So the insulin-to-carb ratio for breakfast will need to be a "tight" one. Such a ratio, for me personally, seems to be 1:5, which means one unit of insulin for every 5 grams of breakfast carbs. It is "tight" because the second number is relatively low, compared to the rest of the day.

Teresa recommended 1:8 I-to-C ratios, for me, for both lunch and dinner. (These numbers are specific to my own case. Other diabetics will typically have different numbers.) But, judging by the fact that I went slightly hypoglycemic last night after dinner, I am now thinking 1:10 for that meal, not 1:8.

For dinner last night I consumed what I estimated to be 55 grams of carbs: five squares of a small pizza at 7 grams per square (if my estimate is correct); 1 bottle of Samuel Adams Honey Porter at approximately 20 grams. Total carbs (55 grams) divided by 8 was roughly 7, so I took 7 units of Humalog insulin. That lowered my blood sugar reading from 113 before the meal to 87 three hours later. Not terribly bad, but not ideal.